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GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

The GMC will introduce ‘emotional resilience’ training and a national support service for doctors after an internal review found that 28 doctors committed suicide while under investigation by the regulator.

The report, Doctors who commit suicide while under GMC fitness to practise investigation, also recommends the appointment of a senior medical officer in charge of overseeing health cases and establishing a culture where doctors feel they are treated as ‘innocent until proven guilty.’

This comes after calls from former RCGP chair Professor Clare Gerada and the BMA among others to publish the findings of the internal review after it was launched in September last year in an effort to see if the GMC can do more to support vulnerable doctors who are undergoing fitness-to-practise investigation.

The internal review identified 114 doctors who had died during 2005-2013 inclusive and had an open and disclosed GMC case at the time of death, and found that 28 had committed suicide.

While it found that the GMC had instigated ‘significant improvements’ to its processes over the past few years, such as using more sensitive language in its letters, it said there was a perception that the GMC focuses on ‘protecting the public’ and that the doctor can become ‘marginalised’ – subsequently receiving little support or compassion.

It said there were a series of recommendations that the GMC could implement to improve processes further, including:

  • Making emotional resilience training an integral part of the medical curriculum;
  • Exposing GMC investigation staff to frontline clinical practice;
  • Supporting the establishment of a National Support Service (NSS) for doctors;
  • Reducing the number of health examiners’ reports required for health assessments;
  • Introducing case conferencing for all health and performance cases;
  • Setting out pre-qualification criteria for referrals from NHS providers and independent employers;
  • Developing a GMC employee training package to increase staff awareness of mental health issues.

Chief executive of the GMC Niall Dickson, said the GMC understands that a fitness-to-practise investigation is a ‘stressful experience’ but he is determined to make sure the regulator handles such cases with sensitivity.  

He added: ‘We know that some doctors who come into our procedures have very serious health concerns, including those who have had ideas of committing suicide. We know too that for any doctor, being investigated by the GMC is a stressful experience and very often follows other traumas in their lives. Our first duty must, of course, be to protect patients but we are determined to do everything we can to make sure we handle these cases as sensitively as possible, to ensure the doctors are being supported locally and to reduce the impact of our procedures.’

Mr Dickson said that a GMC referral will ‘always be a difficult and anxious time for the doctor involved’, but the regulator were determined to make sure they are ‘as quick, simple and as low stress as we can make them’.

He added: ‘We have made some progress on this but we have more to do, and that includes securing legal reform. We will now review our current process for dealing with doctors with health problems and identify any further changes that may be needed.’

Professor Gerada, who leads the Practitioner Health Programme (PHP), which supports doctors with mental health issues, said she ‘applauded the GMC’s openness in putting in the public domain the issue of doctors’ suicides whilst under their process’.

She added: ‘Going forward they need to continue to show their commitment to reducing the impact of fitness to practise investigations on vulnerable doctors whilst always maintaining patient safety - a substantial task.

‘Doctors are sometimes patients too and supporting vulnerable doctors is a shared responsibility. It is important that in taking forward the recommendations in the review the GMC works in partnership with everyone who has an interest in this area including the Practitioner Health Programme, the Royal College of Psychiatrists and the BMA.’

The report states that many of the doctors who committed suicide during this period suffered from a mental health disorder or had drug and/or alcohol addictions.

Meanwhile, other factors which followed on from those conditions that may also have contributed to their deaths include marriage breakdown, financial hardship, and in some cases police involvement as well as the stress of being investigated by the GMC.

Last month, Professor Gerada argued that the GMC’s recent consultation on new sanctions guidance focused too much on ‘maintaining public confidence’ was about basing its decisions on ‘what the tabloid newspapers might think’. 

Related images

  • GMC plaque  Ralph Hodgson - online

Readers' comments (375)

  • Secure environments GP

    Heart-wrenching. This is the caring profession... How many empty seats at family Xmas tables in 6 days time?

    What an awful time it must be for them and for this kind of reminder right now..... when so I am led to believe, the report has been ready to publish for almost a year.

    Clare, thanks for your work. Let's get some more people around the table and change things. This is not just about this report, looking at all pressures on today's doctors - "All that is necessary for the triumph of evil is that good people do nothing." (adapted - Edmund Burke)

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  • Suggesting that we need to have "emotional resilience training" in order to deal with the out of control monster that the GMC has become is like blaming the abused for the abuse that they receive.It is in fact the ultimate demonstration that this organisation doesn't get it. Imagine telling a beaten up wife that she should just toughen up. No we don't need emotional resilience training we need an organisation that demonstrates at least a scintilla of emotional intelligence.

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  • Una Coales. Retired NHS GP.

    Thank you Babak for sharing. You are an example of a near miss suicide while under GMC FTP investigation and you are still suffering PTSD with flashbacks and may still be at risk. The 54% cited is the GMC figure of employer referrals among those who committed suicide while under GMC ix not of college referrals.

    Sadly, for many doctors, they see medicine as their only means of livelihood. We treat mental and physical illnesses in our patients yet doctors are penalised for developing mental disease. When a doctor starts using drugs, abusing alcohol, looking at porn, saying something inappropriate to a patient, is it actually a sign of burnout ie a cry for help?

    I often wonder why the regulator is involved with GP mental health and drug misuse? Surely this is a matter between the PCT/CCG and GP, ie the GP and CCG can make arrangements for cover, a sabbatical, a NHS referral for drug rehab, etc. Why is the GP suddenly made out to be a criminal when they are essentially an unwell patient. Why does the GMC need to investigate an unwell doctor and make him face a traumatic FTP hearing?

    It is a contradiction that the most caring profession is treated so uncaringly. Most cannot afford private lawyers or barristers. If this is the price to work for the NHS, then surely it is too high, to risk mental and physical health and finances? I cannot see how doctors can practice medicine freely, if they have this intense regulator scrutiny, with some referrals, bordering on McCarthyism, hanging over their heads which may materialise as a letter through the letterbox at any time from anyone, even made by an anonymous complainant!

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  • I am currently being investigated for health reasons. I was referred by the man that attacked me and then harassed and tormented me for months. I obviously raised this and concerns about his drinking with the GMC. They opened an "investigation" which involved nothing more than getting some information from his trust, or rather some of his closest friends at his trust. I had reported him to them initially but they failed to conduct an appropriate investigation, repeatedly refusing my offers of evidence etc. The GMC based their entire "investigation" of him on what the trust i.e. his friends, said. I have given the GMC evidence proving my side but they just don't care, they even ignore the discrepancies between the different documents written by him.

    Now on top of everything they are allowing him to seek revenge for me reporting him. Before I even found out about the investigation the GMC disclosed this confidential health investigation to a random consultant that not only did I work with but had been bullying me following communication from this man's trust. They also told my previous trust, i.e. his trust that my current trust raised the concerns rather than him which obviously looks worse. As far as I can tell the person who decided to go ahead with the investigation is not even appropriately qualified to do so.

    The GMC letter I received was completely generic, saying I could get struck off for being attacked and all the other awful things he has done, one of which is too upsetting to mention.

    Throughout all of this my questions to the GMC have been ignored. Investigating me even goes against their own guidance, as does taking no action against him. They have never explained their behaviour in either case. The are rude, show a complete lack of compassion and have and still are making the worst time in my life even worse. He would probably be thrilled reading how many doctors kill themselves over these investigations, hoping I will be one of them.

    The MPS originally said they would represent me, however they made huge and distressing assumptions about the outcome of the case before they knew any of the detail. They asked me for instructions but when I gave them they suddenly refused to represent me. Now they are lying about what they have said despite me having it in black and white.

    The GMC stated that they thought I had what seems to be a slightly lesser version of PTSD after what he is done despite saying he is just fine/innocent. I have just had the first health assessment. However, I wasn't asked about any of what had happened, or how I feel about it, how I am etc. Instead I was told to drop everything in terms of complaining about the man - I am obviously fighting the lack of action by everyone, I have to, I have a responsibility to protect other people from him and I need justice. When I brought up the topic of what had happened the health assessor made it pretty clear that he didn't believe me and was blaming me for what little he apparently did believe. He also said the health assessment is just the first part of things and asked if this was worth losing everything for. That is obviously terrifying. I sat in the car park for an hour and cried and have barely stopped crying since. I haven't been this upset about all of this in months.

    I have repeatedly told the GMC how distressing this is and asked for them to stop and this is ignored. They are fully aware of how much they are hurting me but it seems like this is just some sick game to everyone. I was recently referred as a 2WW and asked if things could be held while I waited for my appointment and was told no. They also attempted to force me into important decisions at a time when they knew I had no legal representation.

    I feel like the GMC are going out of their way to hurt me. If they find a health issue it will be in large part their fault. If they don't I get the impression they will try to hurt me in some other way.

    I don't understand why everyone is so desperate to hurt me. The GMC don't care what they do to people, essentially they are planning to publicly shame me for being the victim of an awful person and I don't know what to do.

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  • This could also potentially be a Human Rights issue.

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  • I made a Freedom of Information request to the GMC entitled:-

    'Non-disclosure of the recent deaths of 86 medical doctors under the activities of the GMC'

    - before I was struck off

    My heart goes out to all my colleagues during this time:-

    'A death-row of turkeys paying for Christmas!'

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  • Reading through these comments is saddening.

    One would have to conclude that becoming a GP is too risky to contemplate, even disregarding QOF, CQC, revalidation etc., since you may not even obtain representation from the defence organisation you pay £000s / year to represent you if you are unfortunate enough to receive an unfounded complaint.

    Amazing too that there is no balance or redress. No chance of counter-suing the vexatious complainant, or indeed seeking redress for the consequences of the GMC's unreasonable and glacially slow procedures (as outlined in previous posts).

    Time to retire, or leave the country, I'm afraid.

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  • Hi Anonymous | Junior doctor | 19 December 2014 7:11pm

    I can clearly read your distress, and I am so sad to see someone worse than me. You obviously need help, but don't know where to look for it.

    I interestingly noticed that whatever is claimed to be the case, is actually not: when you fill in a form to 'make sure you would not be a subject of discrimination for your race, gender, or sexual orientation', it is actually the other way round!

    As you mentioned vulnerability, the GMC do not care if you are a vulnerable doctor; the duty of care is to 'protect the members of public and public opinion of the profession', so there is nothing about doctors; I am so surprised we are expecting this 'new GMC' to advocate people like us. We are 'criminals until otherwise proven' and we are 'liars as long as what we say is different from anyone else, no matter who'.

    The 'system' is clear enough. The GMC is for protection of the public, which we are not part of (as individual 'operators'), and the public reputation of the profession (so anyone who could be made 'a message to the others or to the tabloids').

    What I can tell you my dear, is that you won't get anything from politicians; do not allow a narcissistic, masochistic 'little man' to despair you into darkness. Instead, get help, get well, and fight back! You are not alone, you are not meaningless, you are not nil. Do get well, come along and make it a better world.

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  • Re: Arrogance and insight

    Hi there. Another point I find interesting is the fact that GMC believes that the doctors who are reported ‘are not resilient enough’ to withstand ‘the protective measures that are necessarily taken to protect members of public’. This is what I call ‘lack of insight’ into GMC’s own shortcomings and accusing all those who GMC deals with, as ‘insufficient’.
    Dear GMC, doctors are humans. They often become stressed because of their substandard work conditions. They also are members of public. They also need to be protected. They are not expendable. They are not easy to get. They are easy to lose. We have a shortage of them. Please kindly keep more of them alive.
    I am now moving to another profession; I initially though veterinary medicine, after I was sabotaged in a teaching job. But I’m now turning to information technology. What is interesting is that even if you want to work in McDonald’s, you will be asked why you are changing your career from medical practice, and you won’t have time to answer the question: you’re not fit for work! I’m afraid the bullying wouldn’t stop there. Even if you try to get work in another sector, even if you have a clear ‘enhanced CRB’, you are still not fit for purpose; so all you are left with is to leave the country or become a Heisenberg! Anyway, be well. Merry Christmas.

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  • Why does anyone continue to practice? I thankfully haven't been through this process ...yet ... but the prospect terrifies me. It is inevitable, I see that many people every week, statistically it's almost a certainty. ...complaint rates are rising every year and complaining is actually being actively encouraged. It's dismal.
    I often find myself asking - why on earth did I become a Dr?
    I'm too young to retire but I can't continue working as a GP - even as a Locum.
    Blimey

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